All went well for two years, until she returned to the hospital with sudden right facial drooping and difficulty finding words, sure signs of another stroke, but this time a stroke of a very different kind. A portion of one of the language centers of her brain had been deprived of its blood supply. Her speech was now noticeably impaired. Within a few days, she showed signs of improvement, and was again discharged on a blood thinner. Holy cow!" I said. "It's an ovarian teratoma. You'd better send her over." It was a snap diagnosis, possibly wrong, but there was no harm in raising on a pair of aces. I had a pretty good idea what the other cards would be: memory deficits, gooseflesh, a high heart rate, and no family history of psychosis. The drooling alone was a tip-off. Filled with patient histories and puzzling symptoms waiting to be understood, Reaching Down the Rabbit Hole is a detective novel, and despite his flapping white coat and squeaking Crocs, Ropper is Humphrey Bogart, cerebral yet tough and blessed with a terse wit. -- Christian Donlan * New Statesman *

Reaching Down the Rabbit Hole tells it like it is on the front line of clinical neurology. Engagingly written, informative, often funny, it also manages to be moving without slipping into the sentimentality that too often infests medical writing... If ever anything goes wrong with my brain, I'd like a doctor like Ropper to help sort me out. -- Paul Broks * Daily Telegraph * Nevertheless, there are some wonderful accounts of rare cases, such as the young Asian Korean woman who was fuming like she has rabies. That definitely requires an experienced eye to make an accurate and prompt diagnosis, and to prevent further damage to the patient's physical functioning and quality of life. I liked Dr Ropper, he came across nicely and informally, but his ego can get a bit wearisome after a while. I am trying not to hold the whole ego thing against him, after all he is a neurologist and fair enough he does an amazing job that very few people can or would choose to do.In instances of conversion hysteria, the family of the patient is frequently overbearing and probably causal to the symptoms. Some families demand that the neurologist solve this problem right now and provide a solution that will indicate easy treatment with drugs or reassurance that the illness is nothing to worry about at this point in the patient's life. Either solution is rarely the case. The neurologist is often blamed by these families because he or she is regarded as a shaman who can cure all ills and provide happy endings. Somehow the illness becomes the doctor's fault. Dr Allan Ropper(the author) comes across as the doctor we would all want to have if the chips were down. He seems very approachable and concerned for his patients on the basic, human level as well as treating their illnesses.

At East Shore Hospital an MRI showed an ambiguous blotch on the left frontal lobe of Vincent's brain, and at the suggestion of one of his sons, a pediatrician, the family requested a transfer to us. He arrived sometime around 10:00 that morning and was brought up to the ward. Despite the diagnostic brilliance described in this day-in-the-life portrayal of Dr Ropper’s professional life, the titular rabbit is not that which is traditionally pulled from a hat. Rather, the title refers to the White Rabbit’s entry into Wonderland, where a bewildered Alice is advised by the Red Queen to believe six impossible things before breakfast. That's the pitch. Gilbert has to decide on which specialty to choose by the end of the year, and that is the extent of the effort I will make to sell him on clinical neurology. Rounding on the ward will either appeal to him or it won't. It's not for everyone. Among the residents on the team, who have already chosen neurology, some will concentrate on research and try to find the causes and cures of Parkinson's disease, Alzheimer's, or multiple sclerosis. Some will go into pediatric neurology. Others will become epilepsy or stroke specialists, some will go into psychiatry. But a few special ones, like Hannah, will carry on the clinical tradition, one case at a time. I think this will settle down and there will be a new equilibrium where you're better than you are now. And I hear you, that the dizziness is what's driving you crazy. I know it's frustrating, but your kind of case can't be solved by a book, or it would have been solved by now." Full Book Name: Reaching Down the Rabbit Hole: A Renowned Neurologist Explains the Mystery and Drama of Brain DiseaseArwen Cleary had been a professional figure skater as a teenager, had retired from the Ice Capades upon its dissolution in 1995, had then raised three children, gotten divorced, and moved with her two younger children to a ranch house in Leominster, a distant suburb, where she worked part-time at a local health club. Her medical history was unremarkable: once a smoker, she had quit ten years earlier. Her travels had taken her no place more exotic than Bermuda and no more distant than Orlando. Her only hospitalizations to that point had been in maternity wards. She was remarkably fit and in seemingly good cardiovascular health, if judged only by her appearance and vital signs. But shortly after a visit to a chiropractor, she had suffered a vertebral artery dissection, a form of stroke. An in-the-trenches exploration of the challenging world of the clinical neurologist. From the quotidian to the exotic, from the heart-breaking to the humorous, the authors present an honest and compelling look at one of medicine's most fascinating specialties. * Dr Michael Collins, author of Hot Lights, Cold Steel * Hannah was in charge. Her service, the culmination of three years as a neurological resident, had started a week before I came on board. A "service" involves running the neurology inpatient ward, admitting and discharging the patients, and directing a team consisting of three junior residents, two medical students, and a physician's assistant—a cohort that could barely squeeze into Vincent's curtained-off half of the room.